Mission Trip Application
Name as appears on passport*  
Email Address*  
Primary Phone Number*  
Alternate Phone Number  
Address*  
Date of Birth*  
Occupation or School (if student)  
Church Name and Location  
Marital/Family Status  
Passport Number*  
Passport Expiration Date*  
Which trip are you interested in attending? *  
Have you ever been on a mission trip?  
Briefly describe any previous missions experience (if any).  
How do you know about HIAOM?  
What has led you to want to go on a mission trip with HIAOM?*  
Briefly share about your relationship with Christ.*  
Are you willing to sign a trip Liability and Medical Agreement?  
Have you ever been convicted of a felony, crimes of violence or crime of moral turpitude?*  
If yes...  

If yes, please explain the nature of the offense(s), the number of convictions, how recently such offence(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.
May we run a Criminal History Check on you?*  
Names And Numbers Of 3 References  
Have you read Fields of the Fatherless by Tom Davis?*  
Are there any questions we can answer for you regarding upcoming mission trips?  
Continental One Pass Number  
Verify Word*